To think GP's don't give a shit about menopause

[GentrifiedLDN]

I never realised how hard menopause would hit. For those who haven't been hit this time of their life yet, it fucking sucks ladies - No one and i mean NO ONE tells you how fucking awful this is and how no one gives a shit

I have visited the GP four times now to try and get help, and all they want to do is medicate each individual symptom without addressing the hormone imbalance.

GP seem more concerned about the potential (imo small) risks of HRT than the fact there is a suicidal woman sat in front of them and will fuck you off out the door with a pamphlet about local talking services that take three years to get an appointment at

Anxiety is absolutely awful, it is so bad I have even considered ending it all, as I can NOT live like this much longer

It took my sister four years to get given HRT and feel better.

I am going to have to go private. I can't take this anymore.

I agree (I was put on antidepressants because that's what they do), but I think it's women that the health profession doesn't care about.

@beguilingeyes Did you ever get HRT - what happened in the end, or are you still on anti-depressants?

I had the opposite - put me on HRT despite not having hot flushes or bad periods, when I was struggling with anxiety, forgetfulness and depression. It took Prozac to sort me out.

bupa offer a HRT service £299 all in

You could ask for beta blockers for the anxiety in the interim

I am sorry you are feeling so bad.
Have you an option to speak to another GP? Can you speak to the practice manager and say that the GP might need more training on the menopause?
I have found HRT to be great for my anxiety. Not gone completely but manageable.
It should be possible to say you have menopause symptoms and that you want to try HRT. It might not work - but then would be the time to look at other options.

I am 45 and peri. Have lots of other things going on at the moment that could have been responsible for my overwhelming anxiety and feeling unable to cope with even basic tasks, as well as anger, sadness, and everything in-between BUT my GP listened when I asked for HRT (after a few false starts ie being sent a text with a link to NHS info about the different HRT options, when I'd specifically requested an appointment to discuss the options, after having looked the info up myself...) and prescribed me what I'd asked for.

That was three months ago and just today I've commented to DH that I'm tentatively feeling less panicky and anxious.

I felt suicidal at times recently, I've felt I have no capacity to care for my DC or aging parents, I've felt completely useless in a job I've been doing for 20 odd years. I've felt too tired to move and too lethargic to plan anything. I've felt no joy or excitement in life. Everything has been too much effort and I've felt like I'm wading through mud.

I don't want my hopes to be dashed but I'm taking a tiny bit of comfort in feeling slightly less shite today.

I hope you can see a different GP and get the right treatment. I found Dr Louise Newsom's info helpful as I listed all my symptoms before my GP appt and I hadn't even had the textbook hot flushes that most unenlightened GPs see as menopause 101.

wishing you luck

I haven’t had it as bad as you but I have experienced some negativity for sure they’ve made it v clear they don’t see the davina et al effect as a positive whatsoever

Oh God I'm so scared of this. Since having my kids I have been utterly at the mercy of my cycle in a way I never was before (increasingly black mood until finally suicidal the day before a period, then lifted mood like a light going on the day I come on) - I am so scared of the emotional upheaval of menopause, I'm worried it will affect me so badly and it's rough enough as it is spending 2 weeks of every month affected, but at least it's on a schedule and I know when I'm suicidally depressed and raging it's because I'm due on, what will it be like when my hormones/cycle are all over the place?

What's worse is that I've had depression before and taken ADs (finally weaned off now after having a real dip postnatally) so I know I'll just get dismissed as being 'anxious' etc and palmed off with ADs.

I would definitely try a different doctor - unless there’s a big drip feed and you have breast cancer or another big contraindication I don’t see why most GPs wouldn’t be happy to start you on transdermal oestrogen and a protestagen. The guidelines are very different to 10 years ago and there are very few reasons not to trial HRT.

It amazes me it's still this hard.

OP, have you tried printing off the NICE guidelines when you go in? Not that you should have to do this, and it makes it awkward, but it does say clearly that ADs are not the first choice for women of menopausal age suffering from mood disorders.

Psychological symptoms

1.4.5Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

https://www.nice.org.uk/guidance/ng23/chapter/Recommendations

Done antidepressants do actually have a really good evidence base for helping some symptoms, so women should always be made aware they are an option.
I’m a GP and pretty much the only times I refer to menopause clinic are if a patient has a relevant cancer, or if they are needing higher doses than are licenced, or needing testosterone.

I think it depends on the surgery

I spoke to two HCP who were glowing about HRT

Maybe helped by the fact they were using it, but it couldn’t have been easier

In our practice it’s practically impossible to get an appointment!!!!

I’m sorry this has been your experience, it is very far from my own.

I started experiencing hot flushes aged 47. I asked for hrt and was given it immediately with full advice. Oestrogen only tablets.

I already had a Mirena coil for progesterone.

When I experienced vaginal dryness I was prescribed firstly the pessaries and later switched to cream as it was more effective.

When the tablets were found to be more risky than transdermal application I was moved to patches and later gel ( by far the easiest).

Lastly I enquired about testosterone replacement and was referred to a menopause clinic. I had a consultation within a month ( quite amazingly) and after blood tests it was prescribed and continues via my GP. I’m now 58 so this has been an evolving process.

So I have four different types of hrt, all targeting different issues. All on the nhs and I didn’t fight for any of it. However I did ask specifically for what I wanted. Several friends have complained they were ‘never offered’ any of this but they didn’t ask. Maybe you shouldn’t have to.

OP, please seek more help. There probably isn’t one overall solution but a carefully thought out plan of interventions can transform your quality of life. I’ve heard great things about the Louise Newson clinic if you can afford to pay but honestly it is available on the nhs if you have the energy.

Best wishes.

The only thing GP’s care about is their pay packet…which still isn’t high enough for them!

I went onto HRT but other issues are ignored, eg stress incontinence, memory etc
I am trying to deal with memory and brain fog by doing a martial art that encompasses tai chi style movements and yoga meditation types of activities as well as faster combat.

I read that it restarts parts of the brain, it seems to be helping though. 🤷‍♀️

Not a great experience with a female GP unfortunately - 8 years ago. Finally got HRT 3.5 years ago. So for 4.5 years I just carried on, zombie like until I went to the GP armed with a very long list of symptoms and utter determination to come out with HRT.

It shouldn't be like that though and I'm so sorry you have had this fight on your hands along with dealing with your menopause symptoms. It really is shit.

Oh grow up. GP is just about the hardest job in medicine. And I say that as a consultant in a hospital specialty

My own GP was amazing and my friends have universally had great care. This sort of thread always attracts those who have more to say and scares other posters.

OP if it didn’t go well ask to see a different GP who has an interest in women’s health and specifically say you feel HRT may help. It's important to reflect on how you are presenting. If you are suicidal it would be very remiss of a GP not to try and address this as urgent issue on its own else imagine how they would be accused of negligence if they ‘blamed it all on your hormones’. They can’t win.

I saw Davina's doc, which was a total lightbulb moment. I'd had a coil fitted because of bad flooding, which I realise now that probably meant that I was peri, but nobody suggested that.
I developed crippling anxiety, my work was badly affected..hence the Citalopram.
After the doc I got an appointment with the Newson clinic and got HRT and my GP has now picked up the prescription.

I used to work in a large GP surgery that had a menopause clinic every fortnight ran by a GP and nurse who both specialised in women's health.
This was over ten years ago.

I don't know how common this type of clinic is, but it might be worth looking if any other local surgeries offer better support than yours and moving GP (if you can)

Grow up?! How patronising are you?!
If you are a consultant then perhaps you are just too arrogant to diss your own profession.
GP’s are widely known to be dismissive and ineffective. They don’t even want to do their job - face to face appointment anyone?! You have confirmed what I M saying in your own post - why on earth should OP have to see another GP! The job is supposed to be too important to get it wrong!

I've found the best kind of GP to talk to about it is a woman going through it herself, so if you can make an appointment in your surgery with the GP mostly likely to be female and above around 45, you will probably get a better quality consultation. Or someone who has a specific interest or specialty in women's health.

I absolutely agree OP, it hit me like a train, I had 6 months off work sick, my marriage broke down and I fell apart - my GP was not interested at all.

It definitely must depend on the doctor. I went to see my GP earlier this year to try to get a different type of antidepressant as my anxiety had increased over the past six months (I'm 47). The doc suggested I try HRT instead and it's been amazing - I feel a lot better

@Slippersandacuppatea Bang out of order. OP is clearly suffering, and if your response (as a consultant) is to tell her to "grow up" then I put it to you, that you are in the wrong profession.